Organization
THE SPEECH PATHOLOGY GROUP, INC
Active
Organization
THE SPEECH PATHOLOGY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN M STARK SLP (PRESIDENT)
(925) 945-1474
Entity
Organization
Contact information
Practice address
2021 YGNACIO VALLEY RD STE C202, WALNUT CREEK, CA 94598-3392
(925) 945-1474
(925) 945-1483
Mailing address
2021 YGNACIO VALLEY ROAD, C103, WALNUT CREEK, CA 94598
(925) 945-1474
(925) 945-1768
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SP6948
CA
Other
Enumeration date
02/22/2013
Last updated
08/05/2014
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